Zagazig University Hospitals Research Articles

Relation between sleep quality and glycemic control among type 2 diabetic patients

Abstract Objective: To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients. Methods: Across sectional descriptive design was used; the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals. The interview questionnaire sheet consists of 4 parts: (1) demographic data, (2) medical history, (3) an Arabic version of the Pittsburgh sleep quality index (PSQI), and (4) glycated hemoglobin A1c (HbA1c) analysis test. Results: The mean of sleep duration was the highest score of PSQI components, 96.8% of diabetic patients had poor sleep quality, and 90.4% of diabetic patients had poor glycemic control. A highly statistically significant relationship was found between HbA1c and sleep quality. Moreover, income, duration of disease and smoking were independent positive predictors of HbA1c level, while the female gender was a statistically significant negative predictor. Additionally, female gender and income were statistically significant independent positive predictors of PSQI score. Conclusions: Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients. There was a highly significant relation between sleep quality and glycemic control.

Serum Ferritin Levels and Other Associated Parameters with Diabetes Mellitus in Adult Patients Suffering from Beta Thalassemia Major.

Although beta thalassemia major (BTM) patients are properly treated with blood transfusions in accompany with iron chelation therapy, they suffer from complications, such as diabetes mellitus (DM). The purpose was to detect the critical serum ferritin level and other parameters correlated with DM among adult BTM patients. Also, it was to study whether each of these parameters is associated with a certain period of age. This study included 200 adult BTM patients. A cross-sectional study was carried out. Patients clinical and laboratory variables, such as ferritin levels, and fasting blood glucose (FBS) were extracted from medical records at Zagazig University Hospital, Egypt. Liver and cardiac iron contents were assessed using MRI T2* methods. Statistical analysis was performed using IBM SPSS V26.0 software package. The overall frequency of DM over the total sample equals 6.5%. There were no impaired fasting glucose (IFG) in the medical records. Statistical significance between serum ferritin and DM was (P = 0.014). The serum ferritin 2500 ng/mL with age group (27-<32) years-old were risk factors. The distributions of DM according to BMI were (3.5%) of class overweight. Significant association between DM and BMI was (r = 0.357, P < 0.001). Liver MRI T2* has significant correlation with serum ferritin, but cardiac MRI T2* was poorly correlated. Association between liver and cardiac MRI T2* was not found. Age group (27-<32) years-old and ferritin >2500 ng/mL should be properly treated immediately. The serum ferritin and BMI of class "overweight" were risk factors for DM. Factors such as diet should be followed. Serum ferritin can be used for estimating liver iron content for economic factors. But cardiac MRI T2* must be performed for evaluating cardiac iron accurately.

Maternal Interleukin-17 and disease activity influence pregnancy outcomes in women with psoriatic arthritis and ankylosing spondylitis

ObjectiveWe aimed in this study to evaluate the impact of maternal interleukin -17A and the activity of the illness on pregnancy outcomes in Psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients.MethodsThis prospective cohort research was carried out on 48 Psoriatic arthritis and ankylosing spondylitis pregnant women attending the inpatient and outpatient clinics of the Rheumatology & Rehabilitation and Obstetrics & Gynecology Departments, Faculty of Medicine, Zagazig University Hospitals in Egypt and 30 apparently healthy age- and sex-matched pregnant women between January 1,2018, and December 31, 2019.ResultsThe study group patients had a higher risk of preterm labour (32–36 weeks gestation) (aRR 1.80, 95% CI 0.79–4.17), oligohydramnios (aRR 3.15, 95% CI 1.26–8.42), Caesarean delivery (aRR 1.57, 95% CI 1.41–2.68), and delivering infants small for gestational age (aRR 7.04, 95% CI 2.36–12.42). There was significant difference between the control group and the study groups regarding the level of IL-17A.ConclusionMany females with PsA and AS have uninhibited pregnancy with regard to adverse events, but in comparison with normal pregnancies particularly with high IL-17A during the third trimester we noticed a growing risk of preterm labour, oligohydramnios and cesarean section. Further studies are needed to evaluate high maternal IL-17A levels and fetal outcomes.

Assessment of serum fetuin-A and its gene polymorphism as a marker of insulin resistance in polycystic ovary syndrome

Background/aim Polycystic ovary syndrome (PCOS) is a prevalent endocrine condition affecting 5–10% of reproductive-aged women, the cause of which is unknown. Chronic anovulation, polycystic ovaries, and hyperandrogenism are symptoms of PCOS. It is linked to hirsutism, obesity, and increased probability of cardiovascular disease, metabolic syndrome, and diabetes mellitus. A risk factor for cardiovascular disease is PCOS that is undiagnosed or untreated. Our aim in this study is to investigate serum fetuin-A level and its gene as potential biomarkers for screening of insulin resistance in PCOS. Patients and methods This study involved 100 female participants from outpatient clinic, Department of Obstetrics and Gynecology, Zagazig University Hospital, Egypt. They were split into two groups (each 50). The first group included healthy fertile women without symptoms of hyperandrogenemia as a control. The second group included women with PCOS. Fasting blood sugar levels, cholesterol, high-density lipoprotein cholesterol and triglycerides have been estimated by enzymatic colorimetric technique while low-density lipoprotein cholesterol was calculated. Enzyme-linked immunosorbent assays have been used to measure serum concentrations of luteinizing hormone, follicular-stimulating hormone, testosterone, and fetuin-A, while PCR has been used to extract DNA and genotype common functional polymorphisms in fetuin-A. Results The present results revealed a considerable rise in glucose, insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), cholesterol, triglyceride, low-density lipoprotein cholesterol, luteinizing hormone, testosterone, and fetuin-A and significant decrease in follicular-stimulating hormone and high-density lipoprotein cholesterol in PCOS patients. Also, there was significant higher frequency of the fetuin-A gene variant rs1071592 AA genotype and A allele compared to controls. Conclusions Fetuin-A has a potential diagnostic value as a biomarker for insulin resistance in PCOS associated with metabolic syndrome. Additionally, ‘CG’ allele can be considered a risk factor for PCOS.

Evaluate Nurse's Practice Regarding Neonatal Resuscitation at Zagazig University Hospitals

Evaluate Nurse's Practice Regarding Neonatal Resuscitation at Zagazig University Hospitals

Echocardiographic Parameters of Epicardial Fat Deposition and Its Relation to Severity of Coronary Artery Disease by SYNTAX Score in Zagazig University Hospitals

The thickness of epicardial adipose tissue (EAT) has the potential to act as a novel indicator of cardiac and visceral adiposity and its function in myocardial infarction (MI) diagnosis and therapy.

Nursing counseling utilizing BETTER model on sexuality, marital satisfaction and quality of life among cervical cancer women

Background The most common sexual dysfunction problem for women with cervical cancer is decreased sexual desire. Aim The aim of the present study was to evaluate the effect of nursing counseling guided by BETTER model on sexuality, marital satisfaction, and quality of life among cervical cancer women. Design A quasi-experimental design was used. Patients and methods A purposive sample of 44 women with cervical cancer who attended the oncology outpatient clinic at Zagazig University Hospital and Elmabera Hospital in the Sharkia Governorate was recruited. Tools A structured interviewing questionnaire, Female Sexual Function Index (FSFI), and a short version of the Quality of Life Enjoyment and Satisfaction Questionnaire were used to gather data. Results The mean score of all female sexual function index domains was improved significantly (P&lt;0.001) after intervention as compared with before intervention. Moreover, following applying nursing counseling guided by the BETTER model compared with before intervention, there was a highly significant improvement (P=0.0001) in the quality of life enjoyment and satisfaction among study participants. Following the adoption of the nursing instructions, there was a positive association between the overall Female Sexual Function Index score and quality of life. Conclusion The quality of life and sexual function of women with cervical cancer have improved. Recommendation Implement a BETTER sexual counseling model to handle sexual dysfunction in oncology units. The availability of facilities and decision-making aids for individuals in need, as well as the promotion of women counseling activities about cervical cancer and sexuality, are all necessary.

Functional Abnormalities of the Kidney and Urinary Tract in Malnourished Children in Zagazig University Hospitals

Functional Abnormalities of the Kidney and Urinary Tract in Malnourished Children in Zagazig University Hospitals

Clinical and Prognostic Significance of PD-L1, Beclin 1 and Fascin 1 Immunohistochemical Expression in Colorectal Carcinoma

Introduction: Colorectal Cancer (CRC) is a leading cause of death worldwide, and its incidence has been rising. It is important to identify novel markers that could predict the prognosis of the disease. Aim: To identify the impact of Programmed cell death-ligand 1 (PD-L1), Beclin 1, and Fascin 1 immunohistochemical expression on CRC behaviour and disease prognosis. Also, to assess the different surgical options (laparoscopic versus open) in the management of these patients. Materials and Methods: This cohort study included 72 cases of CRC, conducted in the Pathology, General Surgery, Internal Medicine, Clinical Oncology, and Medical Oncology Departments of the Faculty of Medicine, Zagazig University Hospitals, Egypt between June 2018 and June 2022. PD-L1, Beclin 1, and Fascin 1 expression were assessed immunohistochemically, and their prognostic significance were evaluated. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) 23.0 for Windows (SPSS Inc., Chicago, IL, USA) and NCSS 11 for Windows (NCSS LCC., Kaysville, UT, USA) in the Community Medicine Department, Faculty of Medicine, Zagazig University, Egypt. Results: A significant association was found between PDL1 expression and grading (p-value=0.02), lymphovascular invasion, distant metastasis (p-value=0.001), peritoneal spread (p-value=0.002), tumour budding (p-value=0.005), lymph node metastasis, and American Joint Committee on Cancer (AJCC) stage (p-value&lt;0.001). A significant association was also found between Beclin 1 expression and distant metastasis (p-value=0.001), lymphovascular invasion (p-value=0.004), lymphocytic infiltration (p-value=0.006), perineural invasion (p-value=0.01), peritoneal spread (p-value=0.002), and AJCC stage (p-value=0.007). A highly significant association between Fascin 1 expression and grading, lymphovascular invasion, tumour budding, lymph node metastasis, lymphocytic infiltration, perineural invasion, metastasis, peritoneal spread, and AJCC stage (p-value&lt;0.001) was detected. In patients with negative PD-L1 or high Fascin 1 expression, survival rates were lower. Beclin 1 expression was not associated with a favourable prognosis (p-value&gt;0.05). Conclusion: PD-L1, Beclin 1, and Fascin 1 expression are significantly elevated in CRC tissues and closely associated with adverse prognostic factors. PD-L1 and Fascin 1 expression have important prognostic value and may be of great help in identifying high-risk patients who will benefit the most from treatment.

Pattern and Prevalence of Different Complications of Liver Cirrhosis in Medical Intensive Care Unit of Zagazig University Hospitals

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The role of serum gastric peptide ghrelin hormone level in irritable bowel syndrome at Zagazig University Hospitals

Generalized dysmotility of the gastrointestinal tract develops in individuals with irritable bowel syndrome (IBS). The ghrelin hormone appears to be critical in controlling gastrointestinal motility. We aimed to evaluate serum ghrelin levels in people with IBS and to demonstrate its role in IBS pathophysiology. This study included 32 individuals with IBS (16 with constipation and 16 with diarrhea) and 16 healthy individuals as controls. Blood specimens were collected from patients and controls following an overnight fast. Total ghrelin level was detected in plasma by commercially available ELISA Kit. There were significant differences in the serum levels of ghrelin between the control group and both types of IBS. The mean±SD of ghrelin level in the control group was 2.608±0.714 pg/ml, and that of both types of IBS was 5.782±2.450 pg/ml (P-value<0.001). There was a significant variation between the control and IBS-D groups (mean±SD: 7.838±1.687 pg/ml, p-value<0.001). Also, we indicated a considerable difference between the control and IBS-C groups (mean±SD: 3.726±0.740 pg/ml, P-value<0.001). In comparing the IBS-D group and IBS-C group, we found a highly considerable variation between the two groups (p-value<0.001). This means that serum ghrelin levels were significantly greater in IBS-D than in IBS-C and the control group. Our findings concluded that serum ghrelin level was higher among the IBS-D group than in the IBS-C and control groups. The ghrelin hormone may play a vital role in IBS pathophysiology.

Clinical utility of haematological inflammatory biomarkers in predicting 30-day mortality in hospitalised adult patients with COVID-19.

Coronavirus disease 2019 (COVID-19) is a multisystem disease affecting respiratory, cardiovascular, gastrointestinal, neurological, immunological and haematological systems. The most important indices that have been studied are platelet (PLT) indices in addition to the PLT count and red blood cell distribution width (RDW). This retrospective study included 95 patients with COVID-19 and was conducted at the Hospital Isolation, Scientific and Medical Research Centre and Clinical Pathology Department at Zagazig University Hospitals, Egypt over 6 months from March to August 2021. All patients on admission had a full blood count, which included white blood cell (WBC) count, haemoglobin, RDW, PLT count and its indices in addition to PLT-to-WBC ratio (PWR) and PLT-to-lymphocyte ratio (PLR), which were calculated for all the study patients. There were significant linear correlations for higher levels of the PLR, PWR and RDW and mortality rate (p=0.03, p < 0.001 and p < 0.001 respectively). Moreover, on multivariable analysis the RDW, PLT count and PWR levels were independent prognostic predictors for mortality with a hazard ratio [HR] of 1.25 (95% confidence interval [CI] 1.09-1.44, p=0.002), 1.00 (95% CI 0.99-1.00, p=0.03) and 2.3 (95% CI 1.21-4.48, p=0.01) respectively. The RDW and PLT indices are accessible predictors that can be valuable prognostic factors for survival assessment and risk stratification of COVID-19.

Coronary Calcification in Asymptomatic Metabolic Syndrome

Abstract Aim of the work Noninvasive assessment of the prevalence of coronary heart diseases and coronary artery calcification in patients with asymptomatic metabolic syndrome. Patients and method The study is carried out in cardiology department, faculty of medicine, Zagazig university hospitals it includes 240 asymptomatic patients with metabolic syndrome, all patients were subjected to, history taking, clinical examination, Waist circumference measurement (12), Body mass index (13), twelve leads ECG, Laboratory investigations: and measuring calcium score using multi-slice coronary CT according to the Agatson scale, (14) Results In this study there was no statistical significance association between diabetes mellitus, hypertension, and triglycerides levels and the extent of coronary artery calcification, while there was statistically significant association between coronary artery calcification and reduced HDL, and increased waist circumference. Conclusion Coronary artery calcification screening is an accurate and valuable method for detecting atherosclerotic burden in patients with metabolic syndrome. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.

Impact of chronic liver disease on COVID-9 infection at Zagazig University Hospitals

Impact of chronic liver disease on COVID-9 infection at Zagazig University Hospitals

Management of Post-Bariatric Gynecomastia in Zagazig University Hospitals

Management of Post-Bariatric Gynecomastia in Zagazig University Hospitals

Acute-on-Chronic Liver Failure in Zagazig University Hospital: A Single Center-Based Study

Acute-on-Chronic Liver Failure in Zagazig University Hospital: A Single Center-Based Study

Clinical and Laboratory Characterization of Systemic Lupus Erythematosus Patients with Activity in Zagazig University Hospitals

Clinical and Laboratory Characterization of Systemic Lupus Erythematosus Patients with Activity in Zagazig University Hospitals

Frequency of Insulin Resistance Among Infertile Women with Polycystic Ovary Syndrome at Zagazig University Hospitals

Frequency of Insulin Resistance Among Infertile Women with Polycystic Ovary Syndrome at Zagazig University Hospitals

Assessment of Efficacy of Sublingual Immunotherapy Compared to the Standard Treatment in Children with Bronchial Asthma in Zagazig University Hospitals

Assessment of Efficacy of Sublingual Immunotherapy Compared to the Standard Treatment in Children with Bronchial Asthma in Zagazig University Hospitals

Assessment of Urinary Calprotectin in Early Diagnosis of Intrinsic Acute Kidney Injury in Critically Ill Children at Zagazig University Hospitals

Assessment of Urinary Calprotectin in Early Diagnosis of Intrinsic Acute Kidney Injury in Critically Ill Children at Zagazig University Hospitals